iron infusion

The National Patient Blood Management Collaborative (NPBMC) conducted by the Australian Commission on Safety and Quality in Health Care (ACSQHC) concluded in March 2017.

For the past two years Lismore Base Hospital, St Vincent’s Private Hospital and the North Coast Primary Health Network have been involved in the NPBMC, working towards identifying and managing pre-operative anaemia and/or iron deficiency in patients preparing for major elective bowel, gynaecological and joint replacement surgery. With a particular aim of avoiding blood transfusion, local NPBMC teams concentrated on engaging GPs in the Primary Health Network to optimise patients’ iron and haemoglobin status prior to surgery.

Although the Collaborative has come to a close, local data collection and further work in other surgical streams is ongoing. We aim to optimise pre-operative care for patients undergoing all types of major surgery by complying with the ACSQHC National Health Care Accreditation Standards.

Dr Andrew Binns

Dr Andrew Binns looks at the chequered history of after hours home visits by Australian GPs, and the current scheme’s uncertain future.

I arrived in this region nearly four decades ago, setting up my own solo practice in April 1979 and some years later gained an associate to share the workload. A major factor in encouraging more cooperation with colleagues was the need to provide after-hours care for our patients.

The challenge was to balance this commitment with family life, including factoring in holidays,  plus the demands and expenses that come with running a practice to the level expected by patients and the various regulatory bodies.

As the years passed it became harder and we established a roster for sharing after-hours calls. This included obstetrics cover for some relevantly trained practitioners, including myself. However, even a three-practice amalgamation did not solve the burden of after-hours care provision, so we began to cooperate with other neighbouring practices to further share and manage the workload.

tumeric flowers

Like many foodstuffs whose origins might be obscure to those consuming them, powdered turmeric has an unlikely life, starting as a rhizome, or clumpy root, resembling ginger, and passing through a dramatic seasonal metamorphosis. In any climate cooler than the full-blown tropics it loses its glossy leaves as autumn progresses, and soon disappears from view.

As the weather warms the rhizome shoots of this shade loving plant begin to re-emerge, like caterpillars from their chrysalis, sending up glossy green leaves that by mid-summer will stand more than a metre high and frame beautiful white flowers.

The plant looks so lush that it will never die, and indeed it doesn’t, as the cycle goes on underground, with the rhizomes expanding at an astoundingly rapid rate. While they can be dug up and harvested at any stage, they are best left until early winter when the roots are firm and able to be stored (in my experience, refrigeration spoils them, and ditto for mature edible ginger). Tumeric can be used in curries, blended drinks, adding colour to steamed rice and other recipes.

North Coast Primary Health Network (NCPHN) has launched an Expressions of Interest process to attract individuals with relevant expertise and experience to join a Mental Health and Drug & Alcohol Clinical Expert Panel.

The panel will provide clinical advice and input on the design and monitoring of mental health and drug & alcohol treatment services commissioned by the NCPHN.

After many years of complaints from GPs about the problems associated with paper based reporting, the North Coast BreastScreen Service is to trial an electronic system.

According to Nick Astone, Patient Clinical Information Manager for BreastScreen NSW North Coast, the next version of their information system will contain a GP electronic messaging facility.

Faster processing of abnormal and equivocal reports will reduce both the psychological and physical morbidity of breast screening and will be welcomed by patients and GPs alike.